© Goodheart-Willcox Co., Inc.

7 The Newborn

© Goodheart-Willcox Co., Inc. Key Terms neonate Apgar test Brazelton scale pediatrician anemia phenylketonuria (PKU) jaundice intensive care nursery (ICN) neonatal intensive care units (NICUs) neonatology well-baby checkup reflexes rooting reflex sudden infant death syndrome (SIDS) colic

© Goodheart-Willcox Co., Inc. Objective Give examples of medical care and tests newborns receive at birth.

© Goodheart-Willcox Co., Inc. Medical Care and Testing Neonate is the medical term for a baby from birth to age one month Neonate Immediately after birth, – fluid is suctioned from nostrils and mouth – cord is clipped – baby is dried with warm towels

© Goodheart-Willcox Co., Inc. The Apgar Test Apgar test checks the baby’s chance of survival Apgar test – pulse, breathing, muscle tone, responsiveness, skin color – given one minute and five minutes after delivery five-minute score should be higher – most healthy babies score 6 or 7 at 1 minute, then 8 to 10 at 5 minutes continued

© Goodheart-Willcox Co., Inc. The Apgar Test After the Apgar test, – antibiotic drops are put into the eyes – thermometer is attached to the chest – most newborns receive a vitamin K injection to help their blood clot – some newborns receive a penicillin injection to fight possible strep infection – sample of cord blood is taken to know the baby’s blood type and antibody status continued

© Goodheart-Willcox Co., Inc. The Apgar Test Before baby leaves the delivery room, – footprints are made – name bands are placed around wrists and ankles

© Goodheart-Willcox Co., Inc. Neonatal Behavioral Assessment Scale Brazelton scale helps identify problems as early as possible Brazelton scale – interaction with environment – motor processes – control of physical state – response to stress

© Goodheart-Willcox Co., Inc. Other Screening Tests A pediatrician cares for infants and children until adulthoodpediatrician Screening programs vary for each state – up to 55 disorders – 29 are treatable continued

© Goodheart-Willcox Co., Inc. Other Screening Tests All states check for – anemia anemia – phenylketonuria (PKU) phenylketonuria (PKU) Parents can request tests not required by the state, but must pay for them Jaundice is checked using blood from a heel prick or by a painless monitor Jaundice – treated by placing baby under bright lights

© Goodheart-Willcox Co., Inc. Care for Premature Babies Over 12% of babies born premature Intensive care nursery (ICN) Newborns who need intensive care live in neonatal intensive care units (NICUs)neonatal intensive care units (NICUs) – heated, completely enclosed beds Neonatology is a branch of medicine concerned with the care, development, and diseases of newborns Neonatology

© Goodheart-Willcox Co., Inc. Circumcision Surgical removal of the foreskin of the penis 65% of newborn boys Generally for religious or cultural reasons

© Goodheart-Willcox Co., Inc. Well-Baby Checkup Well-baby checkup is a routine medical visit for new babies Well-baby checkup continued

© Goodheart-Willcox Co., Inc. Well-Baby Checkup Medical personnel will – explore for signs of good health and proper growth – examine baby – answer questions – make recommendations for care – ask for family health history – measure baby’s length, head, chest – weigh baby

© Goodheart-Willcox Co., Inc. Did You Know? The vast majority of newborn deaths take place in developing countries where access to health care is low. Most of these newborns die at home, without skilled care that could greatly increase chances for survival. Learn more about this issue by visiting the World Health Organization Web site.

© Goodheart-Willcox Co., Inc. Objective Describe the characteristics of a newborn.

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Size – weigh about 7 pounds and are about 20 inches long boys slightly larger – lose weight after birth, gain after about 10 days – grow one inch and 1½ pounds during first month – have little body fat continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Body proportion – head ¼ of total length adults 1/8 – rounded chest – protruding stomach, narrow pelvis and hips – legs drawn up and appear bowed – legs short when compared to arms – almost no neck continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Face – broad, flat nose – tiny jaw and chin – facial features help them suck continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Cranium – fontanels soft spots that allow for compression during childbirth fill with bone by one to two years of age membrane that covers fontanels may move as baby breathes – bones of skull are soft may be elongated during childbirth continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Skin – thin, dry, blotchy, visible blood vessels – skin on feet loose and wrinkled – wrists have deep creases – scalp skin loose – languno on ears, shoulders, back, forehead, cheeks (especially premature babies) – rash one to several days after birth continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Skin – stork bites – Mongolian spots African, Asian, Mediterranean descent – may be slightly jaundiced continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Eyes – appear small – usually dull gray-blue until about six months – tears are not produced until about three months – may cross at times, begin to work together at about six months continued

© Goodheart-Willcox Co., Inc. Physical Traits of a Newborn Mouth – puffy cheeks because of sucking pads inside cheeks – short tongue, cannot extend past gums – lining of lips may peel – most are toothless

© Goodheart-Willcox Co., Inc. Reflexes Reflexes are automatic, unlearned behaviors Reflexes Some triggered by outside stimuli Clue to health of nervous system Needed for survival Some stay throughout life, others leave Practice for voluntary movement continued

© Goodheart-Willcox Co., Inc. Reflexes Rooting reflex Palmar (grasping) Plantar (grasping) Babinski Moro (startle) Walking

© Goodheart-Willcox Co., Inc. Objective Identify a newborn’s physical, intellectual, and social- emotional needs.

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Physical Needs Feeding Clothing and dressing Diapering Bathing Sleeping Exercising Scheduling

© Goodheart-Willcox Co., Inc. Feeding Newborns grow quickly, nutrient needs are important Breast- or formula-feeding – American Academy of Pediatrics recommends breast-feeding for first year

© Goodheart-Willcox Co., Inc. Breast-Feeding Advice for mother – eat a balanced diet – drink at least eight 8-ounce glasses of fluid per day continued

© Goodheart-Willcox Co., Inc. Breast-Feeding – may need supplementary vitamin D, iron, and fluoride for baby – certain foods may upset baby’s stomach – prescription and/or over-the-counter drugs can affect baby – rest and avoid stress – consult with a doctor, nurse, or lactation consultant if needed – use breast-feeding time to bond

© Goodheart-Willcox Co., Inc. Formula-Feeding Parents choosing to formula-feed – consult with doctor regarding formula to use – report digestive problems or rashes to baby’s doctor continued

© Goodheart-Willcox Co., Inc. Formula-Feeding – if formula is mixed with water, ensure that water is safe – avoid making formula at home Food and Drug Administration oversees commercially-prepared formulas – feed newborns the correct amount, such as two to 2½ ounces per pound of body weight every 24 hours continued

© Goodheart-Willcox Co., Inc. Formula-Feeding – keep utensils, bottles, and nipples completely clean – keep ready-made formula refrigerated – check nipples for clogs or tears – throw away all unfinished formula – cuddle while feeding to enhance bonding – avoid propping the bottle

© Goodheart-Willcox Co., Inc. Burping the Baby To burp a newborn, – place baby in a sitting position with a hand on the collarbone and under the chin continued

© Goodheart-Willcox Co., Inc. Burping the Baby – lay baby face down across lap with baby’s face toward adult’s knees – lightly pat baby’s back once in position (pat below the ribs for two or three minutes unless baby burps sooner) – burp baby before, midway, and after feeding

© Goodheart-Willcox Co., Inc. Clothing and Dressing Should be comfortable, easy to put on and take off, appropriate for weather Must be flame-retardant – indicated on manufacturer’s tag American Academy of Pediatrics recommends no blankets for first year Interact with baby as dressing and undressing to enhance bonding

© Goodheart-Willcox Co., Inc. Diapering Cloth or disposable diapers – both have advantages and disadvantages cost convenience

© Goodheart-Willcox Co., Inc. What Do You Think? There are often complaints about the impact of disposable diapers on the environment. Cloth diapers are often seen as an alternative that is more environmentally friendly; however, they must be laundered, often in harsh chemicals. What are your thoughts on this issue?

© Goodheart-Willcox Co., Inc. Bathing Sponge baths recommended until the navel completely heals – up to three weeks after birth Keep cord stump dry and never pull on it

© Goodheart-Willcox Co., Inc. Sleeping Average 17 hours per day – as many as 23 hours and as few as 11 hours Light sleepers – seven or eight naps – wheeze, gurgle, suck while sleeping Firm mattress needed Avoid toys and pillows in bed continued

© Goodheart-Willcox Co., Inc. Sleeping Place baby on back Clean pacifier recommended – sudden infant death syndrome (SIDS), baby dies without warning while sleeping sudden infant death syndrome (SIDS)

© Goodheart-Willcox Co., Inc. Exercising Important for muscle development, coordination, and relaxation May become a daily, lifelong habit Way to have fun with babies and develop a warm relationship

© Goodheart-Willcox Co., Inc. Scheduling Feeding and sleeping should be done on the newborn’s schedule – nurse newborns about every two hours – arouse sleeping newborns every three or four hours for feedings Most babies begin to develop eating- sleeping patterns in a few weeks

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Intellectual Needs Parents are child’s first teachers Babies respond to human speech – 12 to 24 hours after birth can move arms and legs rhythmically to human speech – show preference for parent’s voice over a stranger’s voice Imitation of others is common continued

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Intellectual Needs Parents should stimulate babies – stimulation comes from closeness to caregivers Newborns learn through their senses – enjoy looking at and listening to continued

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Intellectual Needs Newborns visual preferences include – designs and patterns that are bold, horizontal, spiral – objects that move – circular-shaped objects – faces

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Social-Emotional Needs Babies learn best when alert continued

© Goodheart-Willcox Co., Inc. Meeting the Newborn’s Social-Emotional Needs Some babies cry one-sixth to one- fourth of the day Colic is a condition in which the baby has intense abdominal pain Colic Attempts to soothe are important – newborns cannot be “spoiled” by attention – babies may not stop crying, but will benefit from soothing attention of adults

© Goodheart-Willcox Co., Inc. Objective Explain how parents of newborns can meet their own needs.

© Goodheart-Willcox Co., Inc. Meeting the Parents’ Needs Rest Organize tasks Take care of new business – birth certificate, social security card Spend time with other adults

© Goodheart-Willcox Co., Inc. What Would You Do? Parents today have been called “helicopters” because of their tendency to hover around their children, hindering independence.  How would you encourage parents to make a life for themselves outside of their role as caregivers of children?

© Goodheart-Willcox Co., Inc. anemia. Condition that occurs when the level of healthy red blood cells, which carry oxygen to all parts of the body, becomes too low. Apgar test. Test that checks the baby’s chance of survival. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. Brazelton scale. Test used to determine whether a baby has problems interacting with the environment, handling motor processes, controlling his or her physical state, or responding to stress. colic. Condition in which a baby has intense abdominal pain and cries inconsolably. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. intensive care nursery (ICN). Special nursery that can provide immediate intensive care just after birth for babies who need it. jaundice. Liver condition that can make the skin, tissues, and body fluids look yellow. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. neonatal intensive care units (NICUs). Heated, completely enclosed beds for newborns who need intensive care. neonate. Medical term used to describe the baby from birth to one month of age. neonatology. Branch of medicine concerned with the care, development, and diseases of newborns. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. pediatrician. Doctor who cares for infants and children until adulthood (age 21 or 22) when physical growth is complete. phenylketonuria (PKU). Disease that can cause mental retardation if left untreated by diet. reflexes. Automatic, unlearned behaviors. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. rooting reflex. Reflex that helps babies search for food by turning the head and moving the mouth in response to a touch on the cheeks or mouth. sudden infant death syndrome (SIDS). Syndrome in which a baby dies without warning in his or her sleep. Glossary of Key Terms

© Goodheart-Willcox Co., Inc. well-baby checkup. Routine medical visit in which the doctor examines a baby for signs of good health and proper growth. Glossary of Key Terms